Caregivers' psychosocial assessment for identifying HIV-infected infants at risk of poor treatment adherence: an exploratory study in southern Mozambique

Caregivers' psychosocial assessment for identifying HIV-infected infants at risk of poor treatment adherence: an exploratory study in southern Mozambique

Psychosocial support (PSS) to caregivers of HIV-infected infants on antiretroviral treatment (ART) is crucial to ensure ART adherence and sustained long-term viral suppression in children. A specific approach including tools to monitor and understand adherence behavior and risk factors that prevent...

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Bibliographic Details
Published in:AIDS care Vol. 35; no. 1; pp. 53 - 62
Main Authors: Lain, Maria Grazia, Chicumbe, Sergio, Cantarutti, Anna, Porcu, Gloria, Cardoso, Loide, Cotugno, Nicola, Palma, Paolo, Pahwa, Rajendra, Pallikkuth, Suresh, Rinaldi, Stefano, Vaz, Paula, Pahwa, Savita
Format: Journal Article
Language:English
Published: England Taylor & Francis 2023
Taylor & Francis Ltd
Subjects:
Adherence
Anti-HIV Agents - therapeutic use
Anti-Retroviral Agents - therapeutic use
Antiretroviral agents
Antiretroviral drugs
Antiretroviral therapy
Caregivers
Caregivers - psychology
Child
Children
Health risks
HIV
HIV Infections - drug therapy
HIV-infected infants
Human immunodeficiency virus
Humans
Infant
Infants
Medication Adherence - psychology
Mozambique
Patient compliance
Patient-centered care
Psychosocial assessment
Psychosocial factors
Psychosocial support
Questionnaires
Relatives
Risk assessment
Risk behavior
Risk factors
Risk taking
Treatment needs
viral suppression
Mozambique
viral suppression
HIV-infected infants
Mozambique
adherence
Antiretroviral therapy
psychosocial support
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Summary:Psychosocial support (PSS) to caregivers of HIV-infected infants on antiretroviral treatment (ART) is crucial to ensure ART adherence and sustained long-term viral suppression in children. A specific approach including tools to monitor and understand adherence behavior and risk factors that prevent optimal treatment compliance are urgently needed. This qualitative exploratory study, conducted in southern Mozambique, monitored the infants' viral response trajectories during 18 months follow-up, as a measure of adherence, reviewed the caregiver's PSS session notes and the answers to a study questionnaire, to analyze whether the standard PSS checklist applied to infants' caregivers can identify barriers influencing their adherence. Only 9 of 31 infants had sustained virologic response. Reported factors affecting adherence were: difficulties in drugs administration, shared responsibility to administer treatment; disclosure of child's HIV status to family members but lack of engagement; mother's ART interruption and poor viral response. In conclusion, we found that the standard PSS approach alone, applied to caregivers, was lacking focus on many relevant matters that were identified by the study questionnaire. A comprehensive patient-centered PSS package of care, including an adherence risk factor monitoring tool, tailored to caregivers and their children must be developed.
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ISSN:0954-0121
1360-0451
DOI:10.1080/09540121.2022.2125159